PREDICTION OF 18-MONTH SURVIVAL IN PATIENTS WITH PRIMARY MYELODYSPLASTIC SYNDROME - A REGRESSION-MODEL AND SCORING SYSTEM BASED ON THE COMBINATION OF CHROMOSOME FINDINGS AND THE BOURNEMOUTH SCORE

Citation
V. Parlier et al., PREDICTION OF 18-MONTH SURVIVAL IN PATIENTS WITH PRIMARY MYELODYSPLASTIC SYNDROME - A REGRESSION-MODEL AND SCORING SYSTEM BASED ON THE COMBINATION OF CHROMOSOME FINDINGS AND THE BOURNEMOUTH SCORE, Cancer genetics and cytogenetics, 81(2), 1995, pp. 158-165
Citations number
38
Categorie Soggetti
Oncology,"Genetics & Heredity
ISSN journal
01654608
Volume
81
Issue
2
Year of publication
1995
Pages
158 - 165
Database
ISI
SICI code
0165-4608(1995)81:2<158:PO1SIP>2.0.ZU;2-7
Abstract
The predictive potential of six selected factors was assessed in 72 pa tients with primary myelodysplastic syndrome using univariate and mult ivariate logistic regression analysis of survival at 18 months. Factor s were age (above median of 69 years), dysplastic features in the thre e myeloid bone marrow cell lineages, presence of chromosome defects, a ll metaphases abnormal, double or complex chromosome defects (C23), an d a Bournemouth score of 2, 3, or 4 (B234). In the multivariate approa ch, B234 and C23 proved to be significantly associated with a reductio n in the survival probability. The similarity of the regression coeffi cients associated with these two factors means that they have about th e same weight. Consequently, the model was simplified by counting the number of factors (0, 1, or 2) present in each patient, thus generatin g a scoring system called the Lausanne-Bournemouth score (LB score). T he LB score combines the well-recognized and easy-to-use Bournemouth s core (B score) with the chromosome defect complexity, C23 constituting an additional indicator of patient outcome. The predicted risk of dea th within 18 months calculated from the model is as follows: 71% (conf idence interval: 1.7-24.8) for patients with an LB score of 0, 60.1% ( 44.7-73.8) for an LB score of 1, and 96.8% (84.5-99.4) for an LB score of 2. The scoring system presented here has several interesting featu res. The LB score may improve the predictive value of the B score, as it is able to recognize two prognostic groups in the intermediate risk category of patients with B scores of 2 or 3. It has also the ability to identify two distinct prognostic subclasses among RAEB and possibl y CMML patients. In addition to its above-described usefulness in the prognostic evaluation, the LB score may bring new insights into the un derstanding of evolution patterns in MDS. We used the combination of t he B score and chromosome complexity to define four classes which may be considered four possible states of myelodysplasia and which describ e two distinct evolutional pathways.